I used a Site analysesurvey.com which is good to create survey like this.

It provide plenty of survey samples to download.

Join as a free user and try it.it is very easy to use

Hello,

I have seen most of the mentioned survey websites offers standard template based solutions only. At times the research requires customized survey, with no mention of the company doing the survey. I like to introduce a company: http://www.surveyrapid.com that offers all such facility considering that respondent/requestor may require assistance over the weekend too. The surveys and URL are completely anonymous. It also offers complicated functionalities like on the fly question generation, file upload feature etc.

They have listed good samples which look very professional:

http://www.surveyrapid.com/Sample_Survey.htm

Hope it helps,

Regards,
Ryan

We use ereseponse interally and now switching to formwise.